Racial Differences in Blood Pressure Control Following Stroke: The REGARDS Study

Area of Science:

• Cardiovascular Health
• Health Disparities
• Stroke Prevention

Background:

• Black adults face higher risks of uncontrolled blood pressure (BP) and stroke compared to White adults.
• High BP is a significant risk factor for recurrent stroke, yet racial disparities in BP control among stroke survivors are understudied.

Purpose of the Study:

• To investigate racial differences in BP control between Black and White adults.
• To examine these disparities in both stroke survivors and individuals without a history of stroke.

Main Methods:

• Utilized data from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke).
• Analyzed participants on antihypertensive medication, comparing BP control at a second visit (2013-2016) based on stroke history (n=306 with stroke, n=7693 without).
• Defined BP control as systolic BP <130 mmHg and diastolic BP <80 mmHg, with specific criteria for older adults (≥65 years).

Main Results:

• Among participants with a history of stroke, 39.3% of Black adults had controlled BP versus 50.3% of White adults.
• Among participants without a history of stroke, 50.2% of Black adults had controlled BP versus 56.0% of White adults.
• Multivariable adjustment showed a trend towards lower BP control in Black participants (PR=0.77 for stroke survivors, PR=0.92 for non-stroke participants).

Conclusions:

• A lower proportion of Black adults achieved controlled blood pressure compared to White adults, irrespective of stroke history.
• Statistical analysis indicated no significant racial disparities in BP control after adjusting for multiple factors.